Updated treatment options for gastroesophageal reflux disease in children: practical guide for clinicians

An age-aware, stepwise strategy - non-pharmacologic first, time-limited proton pump inhibitors with planned step-down, and cautious adjuncts - optimizes outcomes while minimizing harm. Priorities include pediatric trials for potassium-competitive acid blockers (P-CABs) and alginates, validated deprescribing pathways, noninvasive biomarkers, and scalable care models.